Individual
GINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
12170 CORTEZ BLVD, BROOKSVILLE, FL 34613-5578
(352) 346-4131
Mailing address
2124 BLOSSOM CT, SPRING HILL, FL 34608-7111
(352) 346-4131
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT16810
FL
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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